| |
13350 Franklin Farm Road, Ste 300, Herndon, VA 20171-4095 | |
(703) 234-1045 | |
(703) 810-5494 |
Full Name | |
---|---|
Type | Facility |
Speciality | Clinic/center - Multi-specialty |
Location | 13350 Franklin Farm Road, Herndon, Virginia |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1174540215 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Mailing Address | Practice Location Address |
---|---|
Po Box 715868, Philadelphia, PA 19171-6230 Ph: (804) 915-1910 | 13350 Franklin Farm Road, Ste 300, Herndon, VA 20171-4095 Ph: (703) 234-1045 |